Individual provider Active NPI

Kaleb Bohrnstedt

  • Student in an Organized Health Care Education/Training Program
  • Kirksville, MO
National Provider Identifier
1508616699
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
315 S Osteopathy Ave
Kirksville, MO 63501-6401
Phone
(660) 785-1000
NPI assigned
Mar 25, 2024
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

315 S Osteopathy Ave
Kirksville, MO 63501-6401

Mailing address

315 S Osteopathy Ave
Kirksville, MO 63501-6401

Other practice location 1

3595 Olentangy River Rd
Columbus, OH 43214-3440
Phone (614) 566-5456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827003003 OH Order and Referring Only - DermatologyPractitioner - Dermatology 5698214278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1508616699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S OSTEOPATHY AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635016401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S OSTEOPATHY AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635016401",
            "telephone_number": "660-785-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3595 Olentangy River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143440",
            "country_code": "US",
            "telephone_number": "614-566-5456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHRNSTEDT",
        "first_name": "KALEB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.